Kounis syndrome associated with amoxicillin/clavulanic acid

Shimi, Abdelkarim; Touzani, Soumaya; Derkaoui, Ali; Khatouf, Mohammed

doi:10.4103/1658-354x.177329

Cited by 5 publications

(3 citation statements)

References 6 publications

(9 reference statements)

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“…Of the remaining 79 studies, 48 were excluded from the full-text review. A total of 31 studies were included ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Moreno-Ancillo et al, 2004 ; Gikas et al, 2005 ; Del Furia et al, 2007 ; Tigen et al, 2007 ; Tavil et al, 2008 ; Vivas et al, 2008 ; Biteker et al, 2009 ; Caglar et al, 2011 ; Venturini et al, 2011 ; Viana-Tejedor et al, 2011 ; Mazarakis et al, 2012 ; Bezgin et al, 2013 ; Calf et al, 2013 ; Ilhan et al, 2013 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Molina Anguita et al, 2016 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Antonelli et al, 2017 ; Canpolat et al, 2017 ; Omri et al, 2017 ; Pradhan et al, 2018 ; Lopes and Agarwal, 2019 ; Moloney et al, 2019 ; Caragnano et al, 2020 ; Duarte et al, 2020 ). The basic information of these 33 patients is summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The main clinical manifestations of these patients included chest pain in 21 patients (63.6%), allergic reactions (rash, pruritus, erythema) in 25 patients (75.8%), neurological adverse reactions (alteration of consciousness, dizziness) in 10 patients (30.3%), and gastrointestinal adverse reactions (nausea, vomiting, abdominal pain) in 10 patients (30.3%), dyspnea in 6 patients (18.2%), swelling (lips, hands, tongue, face) in 2 patients (6.1%). Thirteen patients had hypotension at the onset of symptoms ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Gikas et al, 2005 ; Vivas et al, 2008 ; Mazarakis et al, 2012 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Duarte et al, 2020 ). Cardiac arrest occurred in 4 patients (12.1%) ( Calf et al, 2013 ; Canpolat et al, 2017 ; Caragnano et al, 2020 ; Duarte et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

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Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

Wang

Zhou²,

Fang³

et al. 2022

Front. Pharmacol.

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Background: The available evidence suggests that amoxicillin is often associated with the occurrence of Kounis syndrome (KS). The purpose of this study is to explore the clinical characteristics of KS induced by amoxicillin.Methods: We searched for case reports of amoxicillin-induced KS through Chinese and English databases from 1972 to May 2022.Results: A total of 33 patients with KS were included, including 16 patients (48.5%) receiving amoxicillin treatment and 17 patients (51.5%) receiving amoxicillin-clavulanate. The median age was 58 years (range 13–82), 75.8% were from Europe and 81.8% were male. Nearly 70% of KS patients develop symptoms within 30 min after administration. Chest pain (63.6%) and allergic reaction (75.8%) were the most common clinical manifestations. Diagnostic evaluation revealed elevated troponin (72.7%), ST-segment elevation (81.2%) and coronary artery stenosis with thrombosis (53.6%). Thirty-two (97.0%) patients recovered completely after discontinuation of amoxicillin and treatments such as steroids and antihistamines.Conclusion: KS is a rare adverse reaction of amoxicillin. Amoxicillin-induced KS should be considered when chest pain accompanied by allergic symptoms, electrocardiogram changes and or elevated levels of myocardial injury markers. Therapeutic management of KS requires simultaneous treatment of cardiac and allergic symptoms. Epinephrine should be used with caution in patients with suspected KS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

Wang

Zhou²,

Fang³

et al. 2022

Front. Pharmacol.

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“…Other than cutaneous type of reaction, amoxicillin causes various other ADRs such as acute generalized pustulosis, agranulocytosis, pancreatitis and Kuoni's syndrome. [17][18][19][20] The practice of reporting ADRs to WHO Uppsala Monitoring centre helps make more decision on framing usage guidelines for drugs. In India the pharmacovigilance program of India (PvPI) receiving the ADR reports from various regional PvPI centers and reporting to WHO centre.…”

Section: Discussionmentioning

confidence: 99%

Amoxicillin induced erythematous maculopapular rashes: a case report

Kumar¹,

Rajganesh²,

Shree³

et al. 2020

Int J Basic Clin Pharmacol

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Cutaneous adverse reactions (CAR) can occur with any class of drugs, however more widely caused by various antibiotics. Amoxicillin is a broad-spectrum, bactericidal, beta-lactam antibiotic, widely used for combating various infections. Cutaneous drug eruptions are known to be reported common while using penicillin class of drugs, specifically among children. These immune-mediated bizarre drug eruptions were range from mild to severe drug-induced cutaneous reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The present case reported with maculopapular, erythematous rashes induced by amoxicillin in a nine-year-old male patient. Amoxicillin was prescribed for his hyperactive respiratory disease and subsequently after three days developed generalized maculopapular erythematous rashes as a result of an antibiotic-induced skin rash. The present case is being reported to add more data, also to emphasize and gather the information for evidence-based practice and to promote efficient pharmacovigilance adverse drug reaction reporting.

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Amoxicillin/clavulanic acid

2016

Reactions Weekly

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Previous studies have demonstrated that Nocardia brasiliensis is susceptible to amoxicillin-clavulanic acid and that its I8-lactamases are inhibited in vitro by, clavulanic acid. A cardiac transplant patient with disseminated infection caused by N. brasiliensis was treated with this drug combination with good response, but relapsed while still on therapy. The relapse isolate was found to be identical to the initial isolate by using genomic DNA restriction fragment patterns obtained by pulsed field gel electrophoresis, but it was resistant to amoxicillin-clavulanic acid. On isoelectric focusing, the ,I-lactamase from the relapse isolate exhibited a shift in the isoelectric point (pl) of its major band from 5.10 to 5.04 compared with the enzyme from the pretreatment isolate. As determined by using values of the amount of ,-lactamase inhibitor necessary to give 50 5% inhibition of P-lactamase-mediated hydrolysis of 50 FM nitrocefin, the I8-lactamase of the relapse isolate was also 200-fold more resistant than the enzyme from the pretreatment isolate to clavulanic acid and was more resistant to sulbactam, tazobactam, cloxacillin, and imipenem. The I-lactamase of the relapse isolate exhibited a 10-fold decrease in hydrolytic activity for cephaloridine and other hydrolyzable cephalosporins compared with that for nitrocefin. Acquired resistance to amoxicillin-clavulanic acid in this isolate of N. brasiliensis appears to have resulted from a mutational change affecting the inhibitor and active site(s) in the

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Kounis syndrome associated with amoxicillin/clavulanic acid

Cited by 5 publications

References 6 publications

Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

Amoxicillin induced erythematous maculopapular rashes: a case report

Amoxicillin/clavulanic acid

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